Dry eye management strategies vary among eye care professionals
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INDIANAPOLIS — Dry eye management strategies vary widely from practitioner to practitioner, highlighting the lack of evidence-based guidelines, according to a poster presented at Academy 2024.
“The reality is that despite all that extra education and showing what the science shows, people haven’t changed that much,” James S. Wolffsohn, BSc, PhD, FAAO, professor and head of optometry at Aston University, told Healio.
To better understand trends in clinical management of dry eye disease, Wolffsohn and colleagues conducted a survey based on management strategies reported by the Tear Film and Ocular Surface Society 2nd Dry Eye Workshop. A total of 905 eye care professionals (42% ophthalmologists, 52% optometrists, 6% opticians) from 56 countries responded.
Independent of dry eye severity and subtype, common treatment options included advice (89%), low (86%) and high (84%) viscosity lubricants, and lid wipes or scrubs (81%), according to results. Biologics and surgical approaches were more frequently utilized with increasing disease severity.
While ophthalmologists were more likely to rely on pharmaceutical treatment, optometrists were more likely to provide advice and recommend over-the-counter products, Wolffsohn said.
In addition, punctal occlusion, oral essential fatty acids, therapeutic contact lenses and secretagogues were more likely to be used for aqueous dry eye disease, while lipid-containing products, lid hygiene and lid warming were more commonly used for evaporative dry eye. Advice, artificial tears and anti-inflammatories were used regardless of dry eye subtype.
“Patients always tell me their top priority is to have a much more standardized approach among practitioners, because they see one practitioner who tells them one thing, but then they go to another practitioner who tells them something different,” Wolffsohn said. “They say in medicine it takes 17 years for clinical research to enter practice, and what we’re seeing is actually it is really difficult to change what clinicians do.”
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Wolffsohn JS, et al. Clinical practice patterns in the management of dry eye disease: A TFOS international survey 2023-4. Presented at: Academy 2024; Nov. 6-9; Indianapolis.
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